Powell, Randell G
Powell, Randell G is an individual health care provider with primary practice located at 1601 S Andrews Ave 3Rd Floor, Fort Lauderdale FL 33316. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Powell, Randell G can be contacted via phone (954) 763-6655.Contact Information
Primary practice address
1601 S Andrews Ave 3Rd Floor
Fort Lauderdale FL 33316
Phone: (954) 763-6655
Fax: (954) 763-6799
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | ME50450 | Florida |
Profile Details
| NPI number | 1629032594 |
|---|---|
| LBN Legal business name | Powell, Randell G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 17th, 2006 |
| Last updated | Jul 29th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629032594 | NPPES |
| Florida | MEDICAID | 270228200 | |
| Florida | Other | 03726 |
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